School Districts Use Data, Routing For Medicaid Reimbursements

January 30, 2025

There’s no getting around the fact that transporting students is an expensive enterprise. Add to that the extra measures needed for serving students with disabilities, and costs grow substantially higher than for other routine operations.

For school some districts, at least a portion of that extra expense is being offset with funds from the federal government. Through provisions in the legislation authorizing Medicaid funding, school systems may file for reimbursement for transportation to and from specified eligible services that students with disabilities need during the school day. These services can include physical therapy, occupational therapy, speech pathology or therapy services, psychological counseling, and nursing services.

Of course, that’s based on acceptable submission of the required reports, which in turn rests on providing accurate ridership figures. Currently, reporting practices vary among school districts across the country, from relying on paper-based approaches to capitalizing on advanced features offered by routing software and related student ridership verification.

Teena Mitchell, special needs transportation coordinator for Greenville County Schools in Greenville, South Carolina, noted that considering the extra costs involved in serving special needs riders, seeking reimbursement is well worth the effort.

“I think it’s safe to say the cost of transporting students with disabilities is substantially higher than transporting those without them and plays a major role in the overall cost of educating our students with disabilities,” said Mitchell, who is also president of the National Association for Pupil Transportation.

Even if reimbursements go back into a school district’s general fund rather than the transportation department’s budget, she added, the dollars benefit the entire district and can be tracked back to the benefit of the transportation department in supporting areas such as personnel, training and equipment needs.

Of the 78,000 students Greenville County serves daily, nearly 16 percent are students with disabilities. The vat vast majority of those students, 88 percent according to Mitchell, receive the same transportation as non-disabled students and ride general education buses. The remaining 12 percent receive specialized transportation and are served on 111 specialized school buses.

Payment is based on a standard amount per trip. For the 2023-2024 school year, the amount was $13.35 per trip although the rate as of Oct. 1 has increased to $29.06. At the standard of $13.35 per trip, a typical school district of Greenville’s size could have expected to receive about $221,000 this school year, Mitchell calculated.

To file for reimbursement, school bus drivers are given a form that lists qualified students listed for the route in question and the dates transported. When two weeks of information has been recorded, a clerk who manages the program enters the information into the Medicaid system for payment.

The school district has routing software but as of this report wasn’t using for tracking Medicaid reimbursements. However, transportation staff were evaluating options for moving in that direction.

This step has already been taken at Colorado’s Weld County School District 6, said Chad Hawley, director of transportation. Routing software is now being used to track ridership in the district’s 60 routes, including 26 designated for serving students who require specialized transportation.

Software features include custom reporting functionality to capture and document data such as days qualifying students rode, where and what time they were picked up and dropped off, and which personnel were involved. A student information specialist incorporates the relevant details in a report that is shared with the Medicaid specialist in the district’s finance department.

Along with improved accuracy, the workload involved in reporting has been reduced.

“We used to have someone collect daily student counts from all of our specialized routes, input the data into a spreadsheet, and then send all the spreadsheets to the finance department,” Hawley noted. “The previous way was time consuming and not always accurate.”

Plans for a similar approach are in the works at El Dorado Union High School District in Placerville, California, where drivers log attendance and submit monthly reports for transportation provided to an average of 130 students who meet Medicaid requirements.

“When drivers turn in reports, they go first to our dispatchers, who enter the data into a shared spreadsheet,” said Sarah Lemke, director of transportation. “This spreadsheet is then accessible to both the finance team and the student success team, which also tracks our McKinney-Vento [Homeless Assistance Act] students.”

This collective info feeds into a report for both state and federal reimbursements.

Transportation staff currently use routing software to support route planning. “While it doesn’t track attendance directly, this capability is expected once we fully implement the software,” Lemke said, adding the goal is to have it fully operational to support Medicaid tracking this school year. “We’re working to streamline this process into one centralized system. The shared Google sheet we currently use has been very effective for transparency across departments, so we’re optimistic that routing will further enhance that.”

Services provided by an outside firm are central to Medicaid reporting at Hutto Independent School District, where the number of special needs riders has been growing. Currently, the school district located northeast of Austin, Texas transports 242 special needs students out of 4,568 total riders, an increase of 14 percent from last year. This necessitates running 15 routes for students with individualized education programs and 35 general routes with some specialty shuttles and McKinney-Vento routes as well, noted David Uecker, director of transportation.

“A contractor does the filing for us,” Uecker says. “We submit rider counts to the company with our [special education] department handling the reporting.”

Hutto leaders plan to enhance reporting with the implementation of new software. Slated for full adoption in the spring, that move will support tracking of riders with disabilities.

Some school districts have elected not to pursue Medicaid reimbursements, at least for now. That’s the case at Deer Creek School District in Edmond, Oklahoma. The district currently utilizes eight routes to transport 100 students with IEPs each school day but meets those demands without additional federal funding.

“The time it takes to go through the reimbursement process makes it difficult to pursue and maintain districtwide,” said Robert Feinberg, transportation director, echoing a common sentiment of peers nationwide.

At the same time, that decision is subject to review. “There is always a possibility of us beginning to use the program,” Feinberg noted. “Our district will continue to evaluate the process versus the manpower it would take to submit the claims.” He said one scenario that might prompt Deer Creek to begin seeking Medicaid funding would be if the school district experienced a large influx of students who meet reimbursement requirements.

Making It Work
Dealing with the federal government is never simple, and the Medicaid reimbursement process is no exception.

Given the complexity involved, good organization is a must. “Prioritize organization from the beginning,” Lemke said. “And establish a reliable system for collecting needed information in advance.”

The same goes for maintaining the necessary knowledge base. “Special needs transportation is definitely a challenge for many districts,” Feinberg said. “Knowing the local, state and federal laws pertaining to their transportation is vital.”

Targeted training can be a key to effective practice in this area, Mitchell pointed out.
“Training your drivers and attendants to be accurate and consistent can be a challenge, especially if you’re in a larger district,” said Mitchell.

Greenville addresses this need during new-hire training, with all incoming transportation employees receiving at least four days of training in transporting students with disabilities. That includes the Medicaid tracking and reporting process in addition to driver training instruction.

“During this training, we impress on the employees the importance of accuracy and remind them that their signature is their assurance that the form is accurate,” Mitchell added.

“Occasionally there may be updates to the process, and when this happens as it did recently, we schedule an in-service training and also give hand-outs with specific instructions.”

Even with the best training, mistakes can occur. To ensure accuracy, Mitchell said she has found it beneficial to have a staff member oversee the process and review the information generated.

Katrina Morris, who directs transportation at both West Shore Educational School District and Mason County Eastern School District in Michigan, advises those in transportation who have not yet pursued this type of funding to consider going for it.

A lot of districts do not realize that there is money for Medicaid reimbursement for students with special needs who require services,” said Morris, who is also the executive director for the Michigan Association for Pupil Transportation. “Please work with your special ed departments to see if this is an option to help receive the funding you are entitled to.”

Mitchell offered similar advice. “If your program is set up and maintained properly, it can run rather smoothly and bring much-needed funding back into the district to offset our diminishing budgets,” she concluded. “These funds can aid you in providing safe transportation with qualified staff.”

Editor’s Note: As reprinted in the January 2025 issue of School Transportation News.